New Doctors: Are White Coat Ceremonies Necessary?

No doctor alive will tell you they can forget their medical school days. From getting straight As in school to scoring high on the SATs to finishing college it was all done with the purpose of entering medical school. It’s hard to dream about simply being a doctor when things get pretty serious during the final years of high school. Your target becomes medical school because despite of how difficult that is, it’s still sounds more realistic and achievable than striving to become a doctor. Some people prefer to set smaller milestones like acing that next test or finishing college with a really high GPA.

Then the moment comes when you get accepted into reaching what you’ve always dreamed of: medical school. The moment is finally here and you’re elated from the moment you get accepted until your first few days there. That elation with time becomes replaced by a little bit of fear and some anxiety. It hits you that you’re going to become a doctor. In a few years you might be the only thing between a person and death or morbidity. That’s huge responsibility that very few people at the age of 21 feel they are up to. As time goes on you grow into the role and step by step you work hard enough so that when the time comes when your patient needs you, you can do something to help them.

A new tradition that has different impacts on medical students emerged in 1989. This is the White Coat Ceremony (WCC). When I say new tradition you have to understand that 30 years is nothing in medicine considering medicine has been around for as long as people have. The tradition started in the University in Chicago in 1989 like we mentioned but the first full ceremony took place in 1993 at the Columbia University College of Physicians and Surgeons. It was created by Dr. Arnold P. Gold who is a pediatric neurologist. The ceremony has since then been adopted in tens of medical schools across the United States. Other countries such as Canada, Israel, Iran, UK, and Brazil have also adopted the WCC. The University of Cologne in Germany started having WCC in 2010 while the University of Graz in Austria adopted the tradition in 2012. It’s not even limited to medical schools as some pharmacy schools perform this ceremony for their students as well.

The timing of the WCC isn’t fixed at all universities. Some choose to have them before the start of the first year of medical school while some have them at the very end after students have completed their studies and are ready to become doctors. The WCC has had various impacts on students. You have to understand that for everyone who dreams of being a doctor the ultimate dream is to wear that white coat. It’s a superhero cape to those who aspire to become the heroes of the world. How someone feels when that moment actually arrives and they do put on that coat is something completely different though. The weight of the pressure could crush you, or you may not feel any sort of burden and simply enjoy the years of hard work that lead to this glorious moment.

A lot of students have written about the negative impact it had on them especially those who had their WCC before they actually started medical school. One student says that he spent his entire life waiting for the moment they could finally put on the white coat but that the moment he actually did he couldn’t take it off quicker. He said that the pressure was too much and he felt like he wasn’t up to it. I think the way he felt was completely justified. Imagine learning how to scrub for surgery only to be pushed into the operating room the next day, handed a scalpel, and asked to perform. Of course it’s not quite the same thing, but in both situations you feel completely out of your depth and at a loss.

No one would dare say that medical school is easy, but non medical people really can’t understand how hard and stressful it is. No matter how much you love studying medicine at some point it will really push you until you feel like you’re going to break (don’t worry, you won’t). It’s not easy being a doctor and it shouldn’t be. Years and years of studying and training are put in before you become the final product who talks to patients and knows exactly what to do like you were born that way. It’s also frightening to think about the information there is. Towards the end of years of medical school I couldn’t help but laugh at how little I knew during my first year or two even though back then I thought I was the boss. These little moments of joy are then interrupted by fear. I start to think that in a few more years I’ll be laughing at how little I know right now and so on. It’s true that the more you know the more you realize you little you actually know. That’s why it’s important to ease medical students into the process or system.

When an 8 year old tells you they want to go swimming you can’t just take a boat into the middle of the ocean then tell them to jump. You don’t even take them to an Olympic swimming pool. First they need to get a feel of the water and know what it’s like in a smaller pool and then they make progress until they don’t even need a boat to get to the middle of the ocean and can swim there themselves. That’s what a medical school should do by taking students step by step until they can handle being physicians on their own.

Medical students aren’t slackers and have worked really hard to get where they are. Some of them are honest enough to admit to themselves that they don’t deserve to wear that white coat yet. Of course for others this isn’t true. They spent years working really hard and they deserve to be celebrated. For them a WCC is a celebration they’ve earned. Maybe they realize they pressure being thrown upon them or maybe not, but for now they don’t care about all that. They worried and panicked too much to get to this so now they’re just going to enjoy it and worry about the rest later.

Perhaps the best option would be to have these ceremonies at the end of medical school like some schools choose to do. You’ve already been eased into the process and graduated. You’re going to become an intern really soon anyway so if you’re not ready for the white coat now, when will you be? It’s like a rite of passage. You’re being handed your white coat by your teachers. To be more accurate, they were your teachers. Now you’re a doctor too and they’re your colleagues. Well, colleagues who will continue to mentor you because of the difference in experience, but let’s not get stuck on the details.

Some of the schools who have the WCC early on also have their students take the Hippocratic Oath during the ceremony. They believe it prepares a student for what to expect and how they should approach medical school. It’s hard to find something that works for everyone. Some people can ignore the pressure while some can’t. Some feel like they deserve to be celebrated and to have their achievements appreciated while to others the road is only starting and feel like they have nothing to celebrate until they get to their ultimate goal. Regardless of how they feel during their white coat ceremony or any other time during their medical school years, medical students always come out on top because that’s what future doctors do.

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